| NPI | 1235663543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARIQ M ABDULAZIZ President/Director 860-377-0641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 001227) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2017-04-13 |